anatomy and injuries of the knee adapted from connie rauser sabino sports medicine
TRANSCRIPT
![Page 1: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/1.jpg)
Anatomy and Injuries of the Knee
Adapted from Connie RauserSabino Sports Medicine
![Page 2: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/2.jpg)
Anatomy-Bones
Bones◦Femur
Medial/lateral femoral condyles articulate w/ tibia◦Tibia
Tibial plateau is flat-articulates w/ femoral condyles
◦Fibula Articulates w/ tibia
◦Patella Sesamoid bone protects anterior joint Enclosed in quadriceps/patellar tendon
![Page 3: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/3.jpg)
Anatomy-Joints
Joints◦Tibiofemoral
Hinge joint with synovial lining ◦diarthrodial
◦Patellofemoral◦Superior Tibiofibular
![Page 4: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/4.jpg)
Anatomy-Meniscus
Meniscus◦Medial and lateral◦Fibrocartilaginous disks
Thicker on outside than inside (poor blood supply)◦Lie on top of tibial plateau◦Increase stability◦Make condyles fit better◦Shock absorbers
![Page 5: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/5.jpg)
Anatomy-Ligaments
ACL-anterior cruciate ligament◦Runs from anterior tibia to posterior femur◦Prevents anterior displacement of tibia on fixed
femur◦Prevents femur from moving posterior during
weight bearing◦Stabilizes tibia against excessive internal
rotation
![Page 6: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/6.jpg)
Ligaments
PCL-posterior cruciate ligament◦Runs from posterior tibia to anterior femur◦Prevents posterior translation of tibia on fixed
femur◦Prevents femur from moving anterior during
weight bearing
Both ACL and PCL “cross” or wrap around each other—taut when in extension and looser when in flexion
![Page 7: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/7.jpg)
Ligaments
MCL-medial collateral ligament◦Attaches on the medial femoral epicondyle &
anteromedial tibia◦Thickened portion of joint capsule◦Two parts-superficial and deep
Deep portion attaches to medial meniscus◦Stabilizes against valgus stress applied to
lateral aspect of joint capsule
![Page 8: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/8.jpg)
Ligaments
LCL-lateral collateral ligament◦Attaches to lateral femoral epicondyle and
head of fibula◦Stabilizes against varus stress when force is
applied to medial aspect of joint
Both the MCL and LCL are tightest during full extension of knee and relaxed during flexion
![Page 9: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/9.jpg)
Ligaments
![Page 10: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/10.jpg)
Muscles
Quadriceps◦ Rectus femoris, vastus lateralis, vastus medialis, vastus
intermedius Knee extension, hip flexion
Hamstrings◦ Biceps femoris, semimembranosus, semitendinosus
Knee flexion, hip extension
![Page 11: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/11.jpg)
Muscles
Gracilis◦Knee flexion, hip adduction
Sartorius◦Knee flexion, hip flexion, hip external rotation
Popliteus◦Knee flexion
Gastrocnemius◦Knee flexion
![Page 12: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/12.jpg)
Muscles
Plantaris◦Knee flexion
Pes anserine◦Goose’s foot◦Knee flexion, some internal rotation
Gracilis, sartorius, semitendinosusIliotibial BandApart of the tensor fascia latae
◦Thick band on lateral aspect of thigh Attaches at Gerdy’s tubercle on the lateral aspect of
tibia
![Page 13: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/13.jpg)
Anatomy of Knee
![Page 14: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/14.jpg)
![Page 15: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/15.jpg)
Preventing knee injuries
Conditioning◦Strength, flexibility, cardiovascular and
muscular endurance Hamstring strength 60% of quad strength
Rehabilitation◦Strengthen all muscles around knee joint
Shoes◦proper type for surface◦Length of cleats◦Turf vs grass
![Page 16: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/16.jpg)
Preventing knee injuries Knee braces
◦ Functional vs. prophylactic Functional—used to provide support to an unstable
knee Usually custom fitted to some degree Uses hinges and supports to control excessive
rotational stress and tibial translation
Prophylactic-worn on lateral aspect knee to protect MCL.
Usefulness questioned—does it cause more injuries?
![Page 17: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/17.jpg)
![Page 18: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/18.jpg)
![Page 19: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/19.jpg)
Muscle Strains
MOI: Sudden contraction of muscle or muscle being
overstretchedS/S:
-Stretching/pulling sensation-Pain with active movement and passive
stretching
![Page 20: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/20.jpg)
![Page 21: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/21.jpg)
Tx: RICE, modalities, alternative training exercises to allow muscle to rest
![Page 22: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/22.jpg)
ACL rupture
MOI: ◦fixed foot and external rotation of femur◦knee in valgus position ◦hyperextension
S/S: ◦“pop”, ◦knee gives out ◦instability of knee joint ◦swelling within knee joint—hemarthrosis ◦intense pain initially but still able to walk◦“+” Lachman’s test◦“+” anterior drawer test
![Page 23: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/23.jpg)
MOI
![Page 24: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/24.jpg)
MOI
Hyperextension
![Page 25: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/25.jpg)
ACL rupture
![Page 26: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/26.jpg)
![Page 27: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/27.jpg)
Inside the knee joint
The ACL intact The ACL torn
![Page 28: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/28.jpg)
ACL Rupture
Tx: RICE, knee immobilizer, crutches, Physician referral
Requires surgical reconstruction◦Timing of surgery decided by athlete, parents,
doctor◦Grafts used are patellar tendon, hamstring
tendon, cadaver graft, allograft◦3-5 weeks in brace, 6-9 months return to
activity
![Page 29: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/29.jpg)
ACL Rupture
Knee post-ACL tear
Test for SwellingBallotable Patella Test
![Page 30: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/30.jpg)
Stress tests
Lachman’s test
![Page 31: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/31.jpg)
Stress tests
Modified Lachman’s
![Page 32: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/32.jpg)
Stress tests
Anterior Drawer test
![Page 33: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/33.jpg)
PCL Rupture
MOI: ◦hyperflexion◦falling on bent knee with foot plantar flexed◦Hit on fixed anterior tibia
S/S: ◦“pop” at the back of knee◦Pt. Tender and swelling in popliteal fossa◦+ posterior sag test,+ posterior drawer test
![Page 34: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/34.jpg)
PCL rupture
Tx:◦RICE◦Immobilization◦Crutches◦Physician referral◦6-8 weeks rest/rehab◦If surgery is elected, 6 weeks immobilization
![Page 35: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/35.jpg)
PCL rupture
![Page 36: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/36.jpg)
Stress tests
Posterior sag
![Page 37: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/37.jpg)
Stress tests
Sunrise or posterior sag
![Page 38: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/38.jpg)
MCL Sprain
MOI: ◦Blow to the lateral side of knee (valgus stress)◦External rotation of tibia
![Page 39: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/39.jpg)
MOI
![Page 40: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/40.jpg)
MCL sprain
2nd degree??
![Page 41: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/41.jpg)
MCL sprain
S/S:1st degree
◦Pt. Tender over MCL, stable but pain with valgus stress, mild joint effusion, mild joint stiffness, full ROM
2nd degree◦Partial tearing-superficial portion, Pt. Tender over
MCL, some instability with valgus stress but solid endpoint, moderate joint effusion, joint stiffness, limited ROM, unable to fully extend knee joint
![Page 42: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/42.jpg)
MCL Sprain
S/S:3rd degree
◦Complete tear—superficial and deep portions◦Pt. Tender over MCL◦Moderate to severe effusion◦Severe pain◦Loss of motion due to pain, effusion, muscle
guarding◦“+” valgus stress in 0 and 30 degrees, no
endpoint
![Page 43: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/43.jpg)
Stress tests for MCL
Valgus stress test @ 0 Valgus stress @ 30
![Page 44: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/44.jpg)
MCL Sprain
Tx:RICECrutchesKnee immobilizer/brace
◦1st degree 1-2 weeks◦2nd degree 2-4 weeks◦3rd degree 4-6 weeks
Physician referral for 2nd degree or greater
![Page 45: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/45.jpg)
Complications
The terrible triad or unhappy triad◦Torn ACL◦Torn MCL◦Torn Medial meniscus
![Page 46: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/46.jpg)
LCL sprain
MOI: ◦ Varus force to medial aspect of knee ◦ internal rotation of tibia
S/S: ◦ Pt. Tender over LCL, ◦ pain, ◦ swelling, ◦ loss of motion, ◦ “+” varus stress at 30 degrees—solid endpoint with 1st
degree, less stability but solid endpoint with 2nd degree, no endpoint with 3rd degree
◦ if “+” varus stress at 0 degrees flexion suspect ACL or PCL injury as well
![Page 47: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/47.jpg)
LCL sprain
Tx:◦RICE◦Crutches◦Knee immobilizer◦Physician referral with 2nd or 3rd degree
![Page 48: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/48.jpg)
Meniscus tear
Medial: more often torn than later due to attachment to MCL
Lateral: doesn’t attach to joint capsule making it more mobile, less prone to injury
MOI:◦Weight bearing with rotational force while
extending or flexing the knee
![Page 49: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/49.jpg)
Meniscus tear
S/S: ◦Effusion w/in 48-72 hours◦Pt. Tender over joint line◦Loss of motion◦“locking”◦Giving out◦Pain with deep knee flexion--squatting
![Page 50: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/50.jpg)
Meniscus tear
Types of meniscus tears
![Page 51: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/51.jpg)
Meniscus Tears Special Test
McMurray TestPositive Sign: Pain and/or clicking
![Page 52: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/52.jpg)
Meniscus tears
Tx: RICECrutches if necessaryPhysician referralIf knee is “locked” by displaced meniscus,
go to ERArthroscopic surgery to fix
![Page 53: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/53.jpg)
Injuries to the Patella
DislocationSubluxationFractureChondromalaciaPatellar tendonitisPatella Femoral Pain Syndrome
![Page 54: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/54.jpg)
Patella Dislocation
MOI: ◦ Foot planted, deceleration, and cutting in
opposite direction from the weight bearing foot◦Thigh rotates internally while leg rotates
externally◦Strong forceful contraction of quads (vastus
lateralis)
![Page 55: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/55.jpg)
Dislocation
S/S: loss of motion/function at the kneePainSwellingDeformityPt. Tender over medial aspect of knee joint
![Page 56: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/56.jpg)
dislocation
![Page 57: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/57.jpg)
dislocation
![Page 58: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/58.jpg)
Dislocation
Tx: immobilize in position you find itIceER visitAfter reduction, immobilize in extension
about 4 weeks—use crutchesStrengthen muscles of knee, thigh and hip
![Page 59: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/59.jpg)
Patella Subluxation
MOI: same as for the dislocationS/S:
◦same as for the dislocation except there will be no deformity
◦Pt. Tender over the medial knee joint◦Pain with movement
TX: ◦RICE◦Knee Immobilizer and crutches◦Physician referral
![Page 60: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/60.jpg)
Patella fracture
MOI: ◦direct impact or trauma to patella◦Indirect trauma in which a severe pull of the
patellar tendon occurs against the femur when the knee if semi-flexed
S/S: ◦hemorrhage which results in significant swelling ◦pain ◦Pt. Tender over Patella◦extreme pain with weight bearing/movement
![Page 61: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/61.jpg)
Patella Fracture
![Page 62: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/62.jpg)
Another x-ray
![Page 63: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/63.jpg)
Patella Fracture
Tx: RICEImmobilizeCrutchesERPossible surgery depending on type of
fracture
![Page 64: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/64.jpg)
Chondromalacia
Softening and deterioration of the articular cartilage on the posterior side of the patella
![Page 65: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/65.jpg)
Chondro
MOI: ◦related to abnormal movement of the patella
within the femoral groove as the knee flexes and extends
◦Lateral tracking patella as quads contract usually associated with weak quads (VMO) or in females a wider pelvis
![Page 66: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/66.jpg)
Chondro
S/S: ◦Pain on the anterior aspect of the knee (behind
the patella) while walking, running, ascending or descending stairs, sqatting or sitting with knees flexed for a long period of time
◦Pain with compression of patella in femoral groove
![Page 67: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/67.jpg)
Chondro
Tx: ◦remove from activities that cause the pain◦Strenghtening exercises for the quads,
especially the VMO◦Knee sleeve with patellar support◦Ice, heat◦Surgery to smooth the posterior side of patella
![Page 68: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/68.jpg)
Osteochondritis Dissecans of Knee
![Page 69: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/69.jpg)
Patellar tendonitis
Also called “jumper’s knee”MOI:
◦excessive running, jumping or kicking causing extreme tension of the knee extensor muscle complex
S/S: ◦Pain at the patellar tendon◦Pt. Tender over the distal pole of patella◦Pain increases with activity◦Thickening of tendon ◦crepitus
![Page 70: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/70.jpg)
Patellar tendonitis
TX: ◦Rest◦Ice ◦Heat◦Ultrasound◦Cross-friction massage◦NSAIDS◦Patellar tendon strap/taping◦Modify activity
![Page 71: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/71.jpg)
Patellafemoral Pain Syndrome
MOI: Overuse and Overload and we just don’t know…Signs and Symptoms:
◦Dull achy pain on or around anterior knee ◦ Pain with walking up or down stairs◦Pain with descending inclines◦Mild Swelling is possible
Tx:◦RICE◦Strengthening and stretching exercises to help
support the tendon◦Active Rest (biking, swimming)
![Page 72: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/72.jpg)
Osgood-Schlatter’s Disease
Condition common in adolescent kneeMOI:
◦Repeated pull of patellar tendon at tibial tuberosity apophysis due to excessive running, jumping, kicking, etc.
S/S: ◦pain and Pt. Tender at the patellar tendon
attachment on tibial tuberosity◦Excessive bony formation over tubersity as
tendon continues to pull at the apophysis
![Page 73: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/73.jpg)
Osgood Schlatter’s
S/S: ◦usually resolves itself when the athlete reaches
18-19 years of age◦Enlarged tibial tuberosity remains
Tx: ◦Modify activity◦Ice◦Tape/patellar tendon strap◦Padding◦Strengthening of quads and hamstrings
![Page 74: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/74.jpg)
Iliotibial Band Friction Syndrome
MOI: ◦Overuse injury that occurs in runners or cyclists
attributed to the malalignment and structural asymmetries of the foot and lower leg
◦Irritation develops over lateral femoral epicondyle or at the band’s insertion at Gerdy’s tubercle on the lateral side of the tibia
![Page 75: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/75.jpg)
ITBS
S/S: ◦Pt. Tender over the lateral femoral epicondyle◦Swelling◦Increased pain with activity especially distance
running and starts and stops and change of direction
![Page 76: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/76.jpg)
ITBS
Tx: Stretching the ITBIce pack/massageTransverse friction massage ITBModify activityCorrect foot/lower leg malalignment
![Page 77: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/77.jpg)
Bursitis
Can be acute, chronic, or recurrentNumerous bursae involved but most
commonly injured are the prepatellar or the deep infrapatellar
![Page 78: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/78.jpg)
Bursitis
MOI: ◦falling directly on knee◦Continuous kneeling ◦Overuse of patellar tendon
![Page 79: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/79.jpg)
Bursitis
S/S: ◦Localized swelling that is similar to a water
balloon and is outside the knee joint◦Pain especially with pressure
![Page 80: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/80.jpg)
Bursitis
![Page 81: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/81.jpg)
Bursitis
![Page 82: Anatomy and Injuries of the Knee Adapted from Connie Rauser Sabino Sports Medicine](https://reader037.vdocuments.us/reader037/viewer/2022103121/56649c7e5503460f949341e0/html5/thumbnails/82.jpg)
Bursitis
Tx: ◦Rest ◦Ice ◦Compression ◦NSAIDS◦Padding for protection when returning to
activity